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  1 / 2252 MEDLINE  
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PMID:27772647
Autor:Choi CS; Hamrah P; Laver N
Endereço:Department of Ophthalmology, Tufts Medical Center, Boston, Massachusetts.
Título:Cystic Compound Melanocytic Nevus in a Pediatric Patient.
Fonte:Ophthalmology; 123(11):2293, 2016 11.
ISSN:1549-4713
País de publicação:United States
Idioma:eng
Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE


  2 / 2252 MEDLINE  
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PMID:29250968
Autor:Tóth G; Sándor GL; Gyenes A; Tóth J; Seitz B; Nagy ZZ; Szentmáry N
Endereço:Szemészeti Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Ülloi út 26., 1085.
Título:[Ocular surface squamous neoplasia].
Título:Szemfelszíni laphám-neoplasia..
Fonte:Orv Hetil; 158(51):2011-2022, 2017 Dec.
ISSN:0030-6002
País de publicação:Hungary
Idioma:hun
Resumo:To summarize actual knowledge on epidemiology, etiology, pathology, clinical apparence and treatment of ocular surface squamous neoplasias. We summarize up-to-date literature on conjunctival intraepithelial neoplasia and invasive squamous cell carcinoma and present some own cases. Ocular surface squamous neoplasia is the most common malignant ocular surface tumor and the third most common ocular malignancy following malignant melanoma and lymphoma. In spite of its low malignant potential, in advanced stages it may reduce visual acuity significantly or even the eye globe has to be removed. In case of metastasis it may also be life-threatening. As local recurrences of ocular surface squamous neoplasias may occur, knowledge of intra- and postoperative adjuvant treatment options are indispensable and regular control examinations are necessary. Identification and adequate treatment of ocular surface squamous neoplasias are necessary in order to avoid its progression and to prevent recurrences. Orv Hetil. 2017; 158(51): 2011-2022.
Tipo de publicação: JOURNAL ARTICLE; REVIEW


  3 / 2252 MEDLINE  
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PMID:29381940
Autor:Moraes BRM; Nascimento MVDD; Neto EDDS; Santo RM
Título:Topical steroids eye drops in conjunctival reactive lymphoid hyperplasia: Case report.
Fonte:Medicine (Baltimore); 96(47):e8656, 2017 Nov.
ISSN:1536-5964
País de publicação:United States
Idioma:eng
Resumo:RATIONALE: Conjunctival lymphoproliferative lesions constitute a significant diagnostic challenge and it is essential to exclude neoplastic lesions. Histopathological and immunohistochemical tests are very useful in establishing the correct diagnosis. Reactive lymphoid hyperplasia (RLH) is part of a spectrum of lymphocytic infiltrative disorders. Evidence is scarce regarding appropriate treatment of conjunctival RLH. We report a case treated with topical corticosteroid. PATIENT CONCERNS: A 40 year-old female presented with a 7-month history of a slow growth tumor in the superior conjunctiva of the right eye. Slit-lamp examination demonstrated salmon colored lesion in the upper conjunctiva, with little conjunctival injection, but no significant neovascularization. There was no eyelid involvement. DIAGNOSES: Ultrasound biomicroscopy showed lesion depth (1.53 mm) and larger diameter (10.73 mm). Pathological examination revealed a chronic inflammatory process with conjunctival folicular hyperplasia. The immunohistochemistry examination showed predominance of CD20, CD23, and CD 3 e CD 5. INTERVENTION: We started topic prednisolone 1% 6 times daily. OUTCOMES: Six months after starting treatment, the lesion completely resolved, without any side-effects or recurrence during three-year follow-up period. LESSONS: Conjunctival RLH can be managed in various ways, depending on patient symptonm, comorbities, and disease distribution. Surgical resection with cryotherapy, radiotherapy, systemic corticosteroids, subconjunctival triamcinolone, and rituximab are some options. There is no strong evidence in the literature of conjunctival RLH successfully treated with topical eye drops corticosteroid. In this report, we obtained completely resolution of conjunctival RLH with topical corticosteroid. CONCLUSION: Topical eye drops corticosteroids are an alternative treatment for selected cases of conjuncitval RLH with no orbital or eyelid involvement.
Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE
Nome de substância:0 (Glucocorticoids); 0 (Ophthalmic Solutions); 9PHQ9Y1OLM (Prednisolone)


  4 / 2252 MEDLINE  
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PMID:27775232
Autor:Pfeiffer ML; Ozgur OK; Myers JN; Peng A; Ning J; Zafereo ME; Thakar S; Thuro B; Prieto VG; Ross MI; Esmaeli B
Endereço:Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Título:Sentinel lymph node biopsy for ocular adnexal melanoma.
Fonte:Acta Ophthalmol; 95(4):e323-e328, 2017 Jun.
ISSN:1755-3768
País de publicação:England
Idioma:eng
Resumo:BACKGROUND: We sought to update our prior report of findings on sentinel lymph node biopsy (SLNB) and predictors of a positive SLN in patients with conjunctival or eyelid melanoma. METHODS: We reviewed the records of all patients with ocular adnexal melanoma who underwent SLNB at one institution during 2000-2015. We determined rates of positive and false-negative findings on SLNB, primary tumour features correlated with positive findings and rate of nodal recurrence (false-negative event) after negative findings. RESULTS: The study included 51 patients, 31 with conjunctival and 20 with eyelid melanoma. These patients include 30 patients who underwent SLNB during 2000-2008, described in our previous report, and 21 additional patients who underwent SLNB during 2008-2015. There were 30 women and 21 men with median age at SLNB of 62 years (range, 24-83). The nodal basins most commonly sampled were intraparotid (27 patients) and level II (14 patients). Ten patients had positive SLNB findings. Compared to tumours with negative findings, tumours with positive findings had greater median thickness (3.5 mm versus 2.2 mm, p = 0.04), greater median number of mitotic figures (6 versus 2, p = 0.03) and greater incidence of ulceration (80% versus 26%, p = 0.003). Perineural and vascular invasion were not significantly associated with positive findings. There were three false-negative events. Three patients (6%) had temporary marginal mandibular weakness which resolved spontaneously. CONCLUSION: SLNB in patients with ocular adnexal melanoma is safe and identifies nodal micrometastasis in approximately 20% of cases. Histologic features associated with a positive SLN included greater tumour thickness, greater number of mitotic figures and ulceration.
Tipo de publicação: JOURNAL ARTICLE


  5 / 2252 MEDLINE  
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PMID:29204645
Autor:Pontes KCS; Groenewoud A; Cao J; Ataide LMS; Snaar-Jagalska E; Jager MJ
Endereço:Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands.
Título:Evaluation of (fli:GFP) Casper Zebrafish Embryos as a Model for Human Conjunctival Melanoma.
Fonte:Invest Ophthalmol Vis Sci; 58(14):6065-6071, 2017 Dec 01.
ISSN:1552-5783
País de publicação:United States
Idioma:eng
Resumo:Purpose: Conjunctival melanoma (CM) is a rare malignant disease that can lead to recurrences and metastases. There is a lack of effective treatments for the metastases, and we set out to develop a new animal model to test potential therapies. Zebrafish are being used as a model for many diseases, and our goal was to test whether this animal could be used to study CM. Methods: Three human CM cell lines (CRMM-1 and CM2005.1, which both harbor a B-RAF mutation, and CRMM-2, which has an N-RAS mutation) were injected into the yolk sac, around the eye, and into the duct of Cuvier of transgenic (fli:GFP) Casper zebrafish embryos. Fluorescent and confocal images were taken to assess the phenotype and the behavior of engrafted cells and to test the effect of Vemurafenib as a treatment against CM. Results: While the cells that had been injected inside the yolk sac died and those injected around the eye sporadically went into the circulation, the cells that had been injected into the duct of Cuvier colonized the zebrafish: cells from all three cell lines proliferated and disseminated to the eyes, where they formed clusters, and to the tail, where we noticed extravasation and micrometastases. Vemurafenib, a potent agent for treatment of B-RAF V600E-positive melanoma, inhibited outgrowth of CRMM-1 and CM2005.1 cells in a mutation-dependent way. Conclusions: The (fli:GFP) Casper zebrafish embryo can be used as an efficient animal model to study metastatic behavior of human CM cells and warrants further testing of drug efficacy to aid care of CM patients.
Tipo de publicação: JOURNAL ARTICLE
Nome de substância:0 (CASP8 and FADD-Like Apoptosis Regulating Protein); 0 (DNA, Neoplasm)


  6 / 2252 MEDLINE  
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PMID:29059312
Autor:Zhou C; Wang Y; Jia R; Fan X
Endereço:Department of Ophthalmology, Ninth People's Hospital of Shanghai, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Título:Conjunctival Melanoma in Chinese Patients: Local Recurrence, Metastasis, Mortality, and Comparisons With Caucasian Patients.
Fonte:Invest Ophthalmol Vis Sci; 58(12):5452-5459, 2017 Oct 01.
ISSN:1552-5783
País de publicação:United States
Idioma:eng
Resumo:Purpose: To evaluate the prognosis in Chinese patients with conjunctival melanoma and determine its predictors. Further, to explore the racial differences in clinical characteristics and outcomes between Chinese and Caucasian patients. Methods: This cohort study included 57 eyes of 57 consecutive patients with pathologically verified conjunctival melanoma between 1996 and 2016. Medical records were reviewed for factors associated with the local recurrence, metastasis, and tumor-related mortality. All eligible patients were followed up for these three outcome measures. The demographic data, clinical characteristics, and outcomes were compared between Chinese and Caucasian patients. Results: The mean follow-up period was 52.2 ± 49.4 months. Among the total 57 patients, 29 (51%) patients experienced local recurrence. The 1-, 5-, and 10-year recurrence rate was 31.0%, 59.7%, and 66.4%, respectively. Treatment complications detected in the follow-up included dry eye (32, 56.1%), irregular eyelid margin (25, 43.9%), eyelid retraction (18, 31.6%), blepharoptosis (9, 15.8%), mixed pigmentation of the tarsus reconstructed by mucosal membrane graft, corneal opacities (6, 10.5%), and symblepharon (2, 3.5%). Twenty (35%) patients developed metastasis. The 1-, 5-, and 10-year metastasis rate was 16.7%, 38.7%, and 50.9%, respectively. Fourteen (25%) patients died of conjunctival melanoma, with a median survival time of 24 months. The 1-, 5-, and 10-year tumor-related mortality was 3.8%, 30.5%, and 37.4%, respectively. Tumor hemorrhage is an independent risk factor for tumor-related death (hazard ratio [HR]: 18.81, P = 0.01) and metastasis (HR: 4.57, P = 0.02). Significant differences were noted between Chinese and Caucasians patients from America, Germany, and England in demographics, clinical characteristics, and outcomes. Compared to Caucasians, Chinese patients tended to have more male cases (P < 0.01) and to be younger (P = 0.03). At initial presentation, more Chinese patients had de novo tumor origin (P < 0.01), epithelioid cell type (P < 0.01), nonbulbar tumor location (P < 0.01), greater basal diameter (P = 0.04), multifocal tumor (P < 0.01), feeder vessels (P < 0.01), eyelid (P < 0.01) and orbit involvement (P < 0.01), and advanced T stages (P < 0.01). Over a similar follow-up period with Caucasians patients (52.2 vs. 52 months, P = 0.97), a significantly larger proportion of Chinese patients exhibited eyelid invasion (P = 0.04) and orbital invasion (P < 0.01) at follow-up, local recurrence (P < 0.01), metastasis (P < 0.01), and tumor-related death (P < 0.01). Conclusions: Conjunctival melanoma is a rare malignancy with great potential for mortality in Chinese. Special attention should be paid to patients with tumor hemorrhage. Compared to Caucasians, Chinese patients exhibit more aggressive clinical signs with compromised prognosis.
Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE


  7 / 2252 MEDLINE  
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PMID:28954115
Autor:Volpini BMF; Maia M; Agi J; Vital J; Lellis RF
Endereço:Dermatology Clinic in the Department of Medicine at Irmandade da Santa Casa de Misericórdia de São Paulo - São Paulo (SP), Brazil.
Título:Synchronous conjunctival melanoma and lentigo maligna melanoma.
Fonte:An Bras Dermatol; 92(4):565-567, 2017 Jul-Aug.
ISSN:1806-4841
País de publicação:Brazil
Idioma:eng
Resumo:Lentigo maligna has an extensive and neoplastic character. It typically progresses slowly and may eventually develop into an invasive melanoma, which is called lentigo maligna melanoma. Ocular melanoma is the second most common type of melanoma. The uvea is the most common site of origin of ocular melanomas, while conjunctival melanoma accounts for about 1-5% of cases. In this article, we describe a rare case of synchronic conjunctival melanoma and lentigo maligna on the face.
Tipo de publicação: CASE REPORTS


  8 / 2252 MEDLINE  
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PMID:28750630
Autor:Ong SJ; Jung SM; Lin HC
Endereço:Department of Ophthalmology, Chang Gung Memorial Hospital, Chang Gung University, Keelung, Taiwan.
Título:Conjunctival lymphoma during pregnancy: a case report.
Fonte:BMC Ophthalmol; 17(1):131, 2017 Jul 27.
ISSN:1471-2415
País de publicação:England
Idioma:eng
Resumo:BACKGROUND: To present a case of conjunctival lymphoma in a young woman complicated by pregnancy. CASE PRESENTATION: A 38-year-old previously healthy woman presented with a 2-year history of progressive right blepharoptosis. Giant papillomatous sessile masses were identified in the upper and lower fornix bilaterally and involved the tarsus of the right upper lid. The remaining ophthalmic examination was unremarkable. Histopathology and immunohistochemistry showed mucosa-associated lymphoid tissue (MALT) lymphoma with immunoglobulin kappa monotype. Further workup showed no evidence of systemic lymphoma or orbital involvement. CONCLUSIONS: Partial regrowth of conjunctival lymphoma occurred 6 months after excision and the MALT lymphoma remained indolent during the course of her pregnancy without radiotherapy.
Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE


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PMID:28673748
Autor:Fabian ID; Thaung C; AlHarby L; Sisley K; Mudhar HS; Doherty RE; Stacey AW; Arora AK; Cohen VML; Sagoo MS
Endereço:Ocular Oncology Service, Moorfields Eye Hospital, London, United Kingdom; Ocular Oncology Service, Goldschleger Eye Institute, Sheba Medical Center, Tel-Aviv University, Tel Aviv, Israel. Electronic address: didifabian@gmail.com.
Título:Late Solitary Extraocular Recurrence From Previously Resected Iris Melanoma.
Fonte:Am J Ophthalmol; 181:97-105, 2017 Sep.
ISSN:1879-1891
País de publicação:United States
Idioma:eng
Resumo:PURPOSE: To report on cases of late extraocular relapse of previously resected iris melanoma, without concurrent intraocular recurrence. DESIGN: Retrospective case series. METHODS: A retrospective chart review of 4 patients diagnosed with late subconjunctival relapse of previously resected iris melanoma. RESULTS: Three female patients and 1 male patient underwent iris tumor resection and presented to our service with suspicious conjunctival lesions at a median of 22 years later (mean: 21 years). None showed intraocular relapse. Treatment of the conjunctival tumors included excisional biopsy (n = 4), followed by cryotherapy (n = 3) and/or brachytherapy (n = 3). In all cases, histopathology confirmed malignant melanoma, with no intraepithelial component or associated melanosis. Genetic sequencing (n = 3) showed wild-type BRAF and NRAS in all. GNA11 mutation was found in 1 case. On array-based comparative genomic hybridization (n = 3), gain of 6p was found in 2 cases and gain of 8 in 2. Overall, findings were strongly suggestive of a diagnosis of late extraocular relapse from previously resected iris melanoma. In a median of 2.5 years (mean: 7.7 years) from the subconjunctival relapse, no further episodes of intraocular/extraocular recurrence were recorded, and all patients were free from distant metastasis. CONCLUSIONS: Patients undergoing iris melanoma resection are at risk of developing late solitary extraocular relapse even more than 30 years after surgery. In the absence of an intraocular component, diagnosis may be challenging, as tumors mimic a primary conjunctival lesion. Management by excisional biopsy followed by adjuvant therapy was successful, and histopathology and genetic analysis supported a diagnosis of extraocular uveal tumor spread rather than a primary conjunctival tumor.
Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE
Nome de substância:0 (GNA11 protein, human); 0 (GTP-Binding Protein alpha Subunits); 0 (Membrane Proteins); EC 2.7.11.1 (BRAF protein, human); EC 2.7.11.1 (Proto-Oncogene Proteins B-raf); EC 3.6.1.- (GTP Phosphohydrolases); EC 3.6.1.- (NRAS protein, human)


  10 / 2252 MEDLINE  
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PMID:28654937
Autor:Cinotti E; Singer A; Labeille B; Grivet D; Rubegni P; Douchet C; Cambazard F; Thuret G; Gain P; Perrot JL
Endereço:Department of Medical, Surgical, and Neurological Science, Dermatology Section, University of Siena, S Maria alle Scotte Hospital, Siena, Italy.
Título:Handheld In Vivo Reflectance Confocal Microscopy for the Diagnosis of Eyelid Margin and Conjunctival Tumors.
Fonte:JAMA Ophthalmol; 135(8):845-851, 2017 Aug 01.
ISSN:2168-6173
País de publicação:United States
Idioma:eng
Resumo:Importance: The clinical diagnosis of conjunctival and eyelid margin tumors is challenging, and new noninvasive imaging techniques could be valuable in this field. Objective: To assess the diagnostic accuracy of handheld in vivo reflectance confocal microscopy (IVCM) for the diagnosis of eyelid margin and conjunctival tumors. Design: A prospective observational study was conducted at University Hospital of Saint-Etienne from January 2, 2011, to December 31, 2016 (inclusion of patients until December 31, 2015, and follow-up until December 31, 2016). A total of 278 consecutive patients with eyelid margin or conjunctival lesions were included. Conjunctival lesions were diagnosed with a conventional clinical examination using a slitlamp and by handheld IVCM. Final diagnoses were established by histopathologic examination for 155 neoformations suspicious for being malignant through clinical and/or IVCM examination that were excised and on follow-up of 12 months or longer for the remaining 140 lesions. Main Outcomes and Measures: Sensitivity, specificity, and positive and negative predictive values for malignant tumors of the conjunctiva and eyelid margin were calculated using clinical examination with slitlamp and handheld IVCM. Results: In the 278 patients (136 [48.9%] females; mean [SD] age, 59 [21] years), a total of 166 eyelid margin and 129 conjunctival lesions were included in the analysis. Of the 155 excised neoformations with a histopathologic diagnosis, IVCM showed higher sensitivity compared with clinical examination conducted with the slitlamp for malignant tumors of the eyelid margin (98% vs 92%) and conjunctiva (100% vs 88%). The specificity for malignant eyelid margin tumors was higher for IVCM than for slitlamp examination (74% vs 46%), but slightly less for malignant conjunctival tumors (78% vs 88%). Analysis of all neoformations (155 excised and 140 in follow-up) confirmed these differences in the diagnostic accuracy of the clinical examination and IVCM. The presence of hyperreflective Langerhans cells mimicking malignant melanocytes was the main cause for misdiagnosis of malignant conjunctival tumors with IVCM. Conclusions and Relevance: Handheld IVCM could be a useful tool for the identification of malignant conjunctival tumors. Further studies are required to confirm the usefulness of this device and identify possible features that can differentiate Langerhans cells from malignant melanocytes to prevent the misdiagnosis of melanoma using IVCM.
Tipo de publicação: JOURNAL ARTICLE; OBSERVATIONAL STUDY



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